An event in the recent past has created shock waves in the national capital. The Noida sisters’, inexplicable decision to deprive themselves of food has made many wonder why someone would endure such misery and mental agony for an extended period time without seeking the necessary treatment. This event has certainly been very disturbing. Recent reports suggest that the sisters faced no financial hardship. The National Commission for Women (NCW) is seeking a report from the administration to better understand the underlying causes of this self-sequestered isolation and the subsequent illness. It is vitally important that this incident is not viewed in isolation but as a part of a much broader health care policy which seeks to alleviate some of the deficiencies which this unfortunate incident has brought to light.
Depression continues to plague the lives of millions in the country. Way back in 2001, a World Health Organization (WHO) study concluded that one in four Indians suffer from a mental illness at any given point in time. We have little reason to believe that things have gotten any better. Longer working hours, the unquenchable thirst to amass more, and the associated stress and anxiety of our hectic lifestyle have made people more vulnerable and hence susceptible to such illnesses. The move from a joint family system to a nuclear family has made people more distant and withdrawn. In some cases individuals are genetically predisposed to this disease.
Compounding these factors is the social stigma and the associated embarrassment that has led to an under diagnosis of this dreadful disease. Victims are often ridiculed. Such was the case with the Behls’ in Noida. Mental health issues continue to be marginalized in our society. An inadequate dissemination campaign has reinforced certain myths about the disease. This has posed formidable obstacles for people who become the victims of this debilitating disease.
India also lacks the physical infrastructure to cope with mental health illnesses. The number of psychiatrists per million is a fraction compared to the developed world. We spend less than 1 per cent of the total national health care budget on mental health. This component is has been grossly underrepresented in the health care policy. A shortage of manpower and inadequate training of health care workers is yet another problem.
The Eleventh Five Year Plan (2007-2012) endeavours to treat mental health diseases at par with other illnesses. Human resources training programmes and spillover schemes have been drafted. Policies have been in place for years now, but the implementation, as is the case with a number of other sectors, seems to be poor. The National Mental Health Programme (NMHP) seeks to address some of the challenges alluded to earlier. Regrettably, the NMHP has lagged behind as noted in the mid term appraisal of the five year plan. It is worth noting that the expenditure is a fraction of the approved outlay. This was 20.81 per cent and 33.26 per cent of the earmarked figure during the fiscal year 2007-2008 and 2008-2009. The numbers portray a very gloomy picture. This certainly does not augur well for the future.
A multi-pronged approach which encapsulates the many facets of the problem is imperative. Comprehensive policy prescriptions and their effective implementation is the need of the day. A robust dissemination campaign which dispels misconceptions in society and alleviates the stigma associated with mental health issues will benefit the hapless victims. As a society, it’s our responsibility to prevent a case similar to the Behls’ in the future.